Sunday, June 26, 2011

Thalassemia patient

I received a mail from a reader regarding Thalassemia patient dietary guide, I have deal with this kind of cases before and I don't mind to share it to all littlediet fans. 
Thalassemia is an inherited autosomal recessive blood disease, to make it simple, there are 2 types of case. The first one is thalassemia major (2 defective genes which need undergo therapy) and the second one is minor (carriers, no symptoms). If the patient is received blood transfusion, then they may need to control the intake of high iron foods. This is related with iron overload problem if blood transfusion but at the same time consumption of high iron foods. Thalassemia is a type of anemia disease. The early destruction of red blood cells cause the oxygen unable be sent to tissues and cells. That's why they need on blood transfusion. The example of high iron foods: seafoods (squid, clams, oysters), internal organs (liver, small intestine, brain), fish roe, raisin, beans, spinach, appropriate amount of chicken, beef and pork. Some of them may also take zinc supplement to chelate (compete) binding with iron to remove excess iron. Besides, patients are encouraged to take tea, coffee, milk, carbonated drink together with meal time to avoid iron absorption. However, they need to avoid taking rich vitamin c  (fruit juice, orange yellow fruits) together with meal as it encourages iron absorption.


Thursday, June 23, 2011

Career development as a Dietitian

Since May, I have been receiving several emails from young reader (this 2 months are the "season" for high school leavers to choose courses for their university) who wish to know more about the career path as a dietitian. They mostly need information about job scope, opportunities and market demand as a dietitian. Honestly speaking, the resources that explain the career of dietitian are limited especially when it comes to real work life sharing from a dietitian. Well, I wish to take this opportunity to explain it, but take note that my thought and information mostly regarding to the career development of a dietitian in my country Malaysia. I compile all question into few Q&A for readers to understand:

a) What is the scope of job for dietitian in Malaysia?
They are few kind of dietitians - Clinical dietitian (that's me, normally work in hospital), community dietitian, food service dietitian, research dietitian (R&D on the hidden usefulness of food) and business dietitian (Marketing but requires dietitian knowledge). 

b) Any advice how to become a good dietitian?
 It is really a need of interest, good communication skill and be patient in doing your job (You are not doctors or pharmacist, so sometimes not every patient or medical specialist will follow your order) . Besides providing dietary consultation, you may deal with some critical illness patient for feeding regime. It is actually quite challenging, critical thinking is a need and good conversation skill with patient (especially speak in different language with people from all sort of race). 

c) Is dietitian a lower class of medical professional?
There is no such thing as who is more important or non-important for medical professional from my opinion, a medical center needs various expertise of people to manage all patients and increase the level of healthcare industry.

d) I heard not every people aware of seeking consultation from a dietitian, so could it be a boring job?
This is very subjective, it depends on area and which type of hospitalization. Normally, government hospital has lots of patient and therefore the case refer from doctors to dietitian increase as well (you can get around 8 patients daily), private hospital is different, not every patient will be refer to dietitian and one main point is patients are not paying to see dietitian, some charges include in the hospitalization package. Once again, it depends on the size of your hospital and area too. If you are working in non-city and non-central hospital, yes, sometimes dietitian is quite free in office. Clinical dietitian needs to give talks to community or any special events once a while (probably once in a month), so it is not easy to become a clinical dietitian. 

e) How to become a successful dietitian?
I can only give opinion from a scope of a clinical dietitian, you can continue pursue study to obtain a phd degree and  get a title of Dr, based on your research knowledge and specific domain, you can get a very well recognizable profile in industry for certain knowledge. Business dietitian earns the most from my opinion (not to compare with a dietitian with phd degree), they sell products and get commission as well, but you need to have marketing skills too.

f) Is clinical dietitian job achieves lowest vacancy compare to other types? 
As mention, each hospital needs few dietitian only and that also applies to larger organization. You must know what kind of dietitian you want to be, work in a hospital/medical center or you have a better social skill which I suggest you to work as nutritionist or consultant. Working in a hospital requires great responsibility.

g) Is it frustrating when people do not listen to your medical advice?
This is a very common question I received. My answer would be no. You have try your best, leave the rest for the will of the patient whether they choose to follow or not. You must always be prepare and well study to provide good explanations in supporting your advice. That's the responsibility.

h) Is it dietitian getting a low paid and appreciation in Malaysia?
This is a tricky question. It depends on whether you value your job most or your paid first. Business dietitian (for example, consultant that sells healthcare package) receives low basic paid too when entering the field, but with hard work and experience, they are gaining the most plus the experience working with hospital party and community side. The entry paid for dietitian in different countries are almost similar except you might take into account of currency.

i) In short, what is the advice for fresh nutrition/dietitian student?
Your path may varies on the road of your studying in degree and you may not know what will you end up after graduate, so my advice is plan well on your study, read more on medical professionals research work, and you will get a clearer picture of what you want to end up in. For me, I didn't really look on salary and burden of work when I join as clinical dietitian. I took a helpful and caring heart to dive into this area than anything.

I am welcome for any dietitian to share with me their career path and their thought of a job as a dietitian/nutritionist. Cheers.

Thursday, June 16, 2011

E.coli - What's it?

I hope all reader are aware of lately one of the hottest topic of food is E.coli. A large exposure in Germany on  E.coli bacteria infection through raw vegetables (the first trace of the root of infection is cucumber and now is confirmed from bean sprouts sources grown on a farm in northern Germany). It is being suspected the reason behind is due to contaminated water that use for bean sprouts as water supply. Germany Robert Koch Institute (RKI) has announced that contaminated bean sprouts were the source of the outbreak. Travelers should aware that the recommendation not to eat cucumbers, tomatoes and leafy salads.
I took some time to study these kind of case before sharing on my blog. The specific E.coli strains that cause outbreaks of disease in this incident are named as E.coli 0104:H4. Patients may experienced hemorrhagic colitis (inflammation and bleeding of the colon). Let's know what can E.coli cause, EHEC and HUS. EHEC 
is refer as Hemorrhagic (bloody) diarrhea: an increased amount of blood in the diarrheal stool that doesn't
resolve and is usually accompanied by severe abdominal pain. Although this may resolve within a week, some individuals can develop anemia and dehydration that can cause death. Hemolytic-uremic syndrome (HUS) : symptoms of pallor (due to anemia), fever, bruising or nose bleeding, fatigue, shortness of breath, swelling of the body, especially hands and feet, jaundice, and reduced flow of urine may be seen. HUS symptoms usually develop about 7 to 10 days after the initial diarrhea begins. HUS is the most common cause of kidney failure in children that damage the kidneys and destroys platelets which can lead to kidney failure, excessive bleeding, seizures or death.
Prevention includes eating well cooked foods, and drinking treated or pasteurized fluids. Avoiding touching or eating any food that may be contaminated with any animal or human waste will help to prevent the infection too. When you are preparing any fresh produce, begin with clean hands. Wash the produce under running water just before preparing or eating. This includes produce that grown conventionally or organically at home, or produce that is purchased from a grocery store or farmer's market.
Furthermore, proper storage of fresh produce can affect both quality and safety. Certain perishable fresh fruits and vegetables (like strawberries, lettuce, herbs, and mushrooms) can be best maintained by storing in a clean refrigerator at a temperature of 40° F or below. All produce that is purchased pre-cut or peeled should be refrigerated to maintain both quality and safety.

Folks, prevention is better than cure. Do practice a good hygiene as a first step to good health. Cheers.


正确的新鲜农产品储存,可影响质量和安全。某些易腐新鲜水果和蔬菜(如草莓,生菜,草药和蘑菇)最能维持在一个干净的冰箱储存在一个40 ° F或以下的温度。如果你不能确定是否应冷藏为维护品质,在还未买时请您询问详情。所有购买预先切开或去皮的食物应该冷藏以维持质量和安全

Monday, June 13, 2011

Protein via vegetarian diet

If you followed my previous post, I mentioned it is true vegetarian diet plan may suffer from deficient in nutrients especially in proteinGrain foods, such as bread, cereal, pasta, rice, nuts, beans and tofu are just few vegetable-based foods that contain protein. We can get complete protein by eating a varieties of plant foods. For example, grains are low lysine and moderate methionine while legumes are low methionine, moderate lysine. Thus, if we take this 2 types of foods, can enable our body to have a complete protein that we need. 
I include a table to explain my planning on vegetarian diet for adequate protein supply. 

Sesame seeds
Sunflower seeds
Dried peas
Pumpkin seeds
Soy products
Other nuts

Example menu to learn how to combine different source of plant to provide a complete protein for our body.

Limiting Amino acids
Completementary foods
Example menu
Legumes: lentils, peas, beans
Trytophan, methionine
Grains, nuts and seeds
Legumes+ grains
Grains: wheat, corn, rice, oats, barley, rye
Lysine, isoleucine, Threonine
Grains + legumes
Nuts & seeds: Almonds, peanuts, sunflower, cashews
Lysine, isoleucine
Nuts / seeds + legumes




Thursday, June 9, 2011

Vegetarian diet - Protein?

Littlediet continues with the topic of vegetarian diet. When we develop vegetarian diet in our daily life, we directly practice a healthier eating habit. As known, vegetarian diet can increase vegetables, legumes, nuts and fruits consumption and reduce meats intake. Meats especially red meats (beef, lamb, pork) contain high saturated fat and cholesterol (for skin part, fatty part, internal organs (liver, heart)). Meats will make our blood more acidity while plant sources of foods make our blood alkaline. Our body needs a neutral condition for optimal organ function. When we reduce those harmful substance intake and replace with healthier green foods, those healthy foods will acts as a cleaner to help us detoxify those harmful substances and alkaline blood stream in our body. Thus, well balanced vegetarian diet is appropriate for all stages of life.
Vegetarian diets have been described as being deficient in several nutrients including protein, iron and others nutrient. Therefore we should include as complete as possible for type Amino acids (protein) in our daily meal. Unless we plan carefully, else vegetarian diet may be nutritional inadequate. Plant sources of protein include legumes (soybeans; peanut; beans (pinto, navy, baked beans, red beans, mung beans, kidney bean), and peas (blackeye, chickpea), grains, nuts and seeds. Plant sources of protein differ from animal sources such as meat, milk, and eggs in that most plant sources are not complete proteins. A complete protein is one that contains all the essential Amino acids (EAA) in sufficient amount for growth and maintenance tissue support. Those EAA is unable to be produced by our body but is needed in our body. Therefore, a vegetarian who doesn't plan his/her meal right may end up suffering from low level of one or more essential amino acids. Well, you don't really need complete proteins all in the same meal, simply make sure you eat a variety of protein sources throughout the day, from nuts to seeds, to rice and grains. Another option is to get some soy into vegetarian diet because it offers a complete protein. To vegetarian, take note of diet planning!


Saturday, June 4, 2011

A BMI widget

Few days ago when I was trying on blogspot widget to find if any BMI calculator to be added into my page, it turns out to be widget with ads or Europe standard of measurement parameters. So I decided to write one, this is my first time writing HTML code and I hope is good enough to produce a simple and nice widget. Anyway, HTML5 tutorials lessen my job a lot. From here as a starting point, I will roll out more calculator for dietary related in future. Based on the BMI calculator I designed, it is in kilogram for weight and centimeter for height. If you wonder how to convert from a standard to another, below provide a little tips for you all.

You are 1.61 m, 50 kg

1kg=2.2 pounds
50kg=50x 2.2=110 pounds

1 feet= 12 inches
1 inches= 2.54 cm
1.61m= 161 cm
161 divide by 2.54 =63.4 inches
63.4 divide by 12= 5 feet 3 inches

Thursday, June 2, 2011

Vegetarian diet

Hi, littlediet is back. The new topic will be covering all about vegetarian, just because I found that there are lesser related information we can grab online. Choosing between a vegetarian diet and a meat-eating diet is a very personal and individual decision that should be made with as much information and education as possible. 
If you plan to include 1 to 2 times of vegetarian diet in your weekly meal, you are giving yourself a chance to enjoy more variety of vegetables at the same time support for earth to reduce dependency on animals and animal’s products. Besides, you might be able to avoid some negative consequences of animals and animals products on our bodies. This is relating with some issues that animals are raised with the use of antibiotics and growth hormones, especially commercial meats (sausage, nugget, ham and others processed foods). Farmers use antibiotics on their livestock to prevent them from the diseases of animals while growth hormones are being used for animals to grow larger in a short period. This can let them earn more in a short season. Recently, there are news reports about fake meats being sold around the market (Although I haven't encounter similar case in hospital, these kind of case is popular among society). Thus, we should choose products from reliable supplier or try to reduce frequency of consuming meats and say 'hi' to vegetarian diet. But, is vegetarian diet provide us the adequate nutrient we need daily? Is vegetarian diet suitable for children who are having growing period? The answer to this question will be reveal slowly in next few post. Cheers.